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Validity of current clinical criteria for Alzheimer's disease, vascular dementia and dementia with Lewy bodies

Published online by Cambridge University Press:  02 January 2018

Clive Holmes ,
Nigel Cairns ,
Peter L. Lantos  and
Anthony Mann
Clive Holmes*
Affiliation:
University of Southampton, Thornhill Research Unit, Moorgreen Hospital
Nigel Cairns
Affiliation:
Brain Bank Research Laboratory, Department of Neuropathology
Peter L. Lantos
Affiliation:
Institute of Psychiatry, De Crespigny Park, London SES 8AF
Anthony Mann
Affiliation:
Institute of Psychiatry, De Crespigny Park, London SES 8AF
*
Dr Clive Holmes, University of Southampton, Thornhill Research Unit, Moorgreen Hospital, Botley Road, West End, Southampton SO30 3JB. Tel: (+44) 01703 475446; Fax: (+44) 01703 475446
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Abstract

Background

Following the success of the NINCDS–ADRDA criteria for Alzheimer's disease, groups interested in vascular dementia and dementia with Lewy bodies have now adopted similar criteria.

Aims

To assess whether the validity of these criteria are influenced by the prevalence of mixed pathologies or by the prevalence rate.

Method

A community based postmortem study.

Results

Mixed pathologies were common (33.8%). The high specificities obtained for the CDLB and NINDS–AIREN criteria (1.00 and 0.95, respectively) were associated with low sensitivities (0.22 and 0.43, respectively). Low prevalence and the presence of mixed pathologies had a deleterious effect on positive predictive values.

Conclusions

Current clinical diagnostic criteria are good at detecting pathology per se but not at detecting pure pathology. A large proportion of subjects from the general population fulfilling probable CDLB, probable NINCDS–ADRDA or probable NINDS–AIREN will have mixed pathologies.

Type
Papers
Information
The British Journal of Psychiatry , Volume 174 , Issue 1 , January 1999 , pp. 45 - 50
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

Supported by the Medical Research Council (UK) and by a project grant from the Wellcome Trust.

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